新生儿缺氧缺血性脑病57例血浆性激素水平的临床意义

The changes of gonadal hormone levels in 57 neonates with hypoxic-ischemic encephalo-pathy

目的:研究血浆雌二醇(E2)和睾酮(T)在新生儿缺氧缺血性脑病(HIE)发病过程中的变化,探讨二者与HIE发生和发展的关系,为临床诊断和治疗HIE提供指导。方法:采用电化学发光仪测定57例HIE急性期、恢复期和30例对照组患儿血浆E2、T水平,并根据新生儿行为神经测定(NBNA)协助判定预后,并对所有数据进行统计学处理。结果:急性期中、重度HIE患儿与轻度和对照组比较,血浆E2、T明显升高(P<0.05),恢复期中、重度HIE患儿与轻度和对照组比较,血浆E2、T水平明显降低(P<0.05)。中、重度HIE患儿急性期与恢复期比较,血浆E2、T明显升高(P<0.05),而轻度和对照组急性期与恢复期比较差异无统计学意义(P>0.05)。不同程度HIE患儿恢复期的血浆E2、T变化与NBNA评分相一致。结论:E2、T参加了新生儿HIE的发生和发展过程,急性期及恢复期的血浆E2、T水平与HIE病情程度密切相关,恢复期的血浆E2、T水平为HIE的预后和治疗提供指导。

Objective：To investigate the levels of blood plasma estradiol （E2） and testosterone （T） in neonatal hypoxic-ischemic encephalopathy （HIE） and explore the relation of blood plasma E2 and T with the developing of HIE, and to supply guidance for diagnose and therapy of HIE. Methods：Blood plasma E2 and T levels were measured by electrochemil in 57 neonates with HIE （21 mild,21 moderate, 15 severe HIE） at the acute and convalescence stages. Thirty neonates were used as control. Results：Blood plasma E2 and T were significantly higher at acute stage but significantly lower at convalescence stage in moderate and severe HIE neonates compared with those of control and mild HIE neonates. Blood plasma E2 and T decreased in moderate and severe HIE neonates at convalescence stage compared with those at the acute stage. The diversity of blood plasma E2 and T were unification with the levels of NBNA. Conclusion：E2 and T might be involved in the pathophysiological process of HIE. The levels of E2 and T closely relate to the severity of HIE.